Early targeted antimicrobial therapy and source control during sepsis
Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection (Sepsis-3 definition). In 2017, the World Health Organisation (WHO) declared sepsis to be a world health priority. Sepsis affects millions of people causing death in many cases (10-50%) and putting heavy social and economic burdens on our societies. For 2017, the WHO reported 48.9 million cases of sepsis globally and about 11 million sepsis-related deaths. The cost of treating sepsis is enormous: in 2008, USD 14.6 billion was spent in the US alone (with an average growth rate in cost of 11.9%). Most types of microorganisms can cause sepsis. However, the vast majority of cases is caused by bacteria and fungi.
A swift identification of the sepsis-causing pathogen is essential to start an individual and targeted antimicrobial therapy as soon as possible. Initial empirical therapies are often ineffective and boost antibiotic resistances of wrongly treated microorganisms.
But this identification still largely depends on microbiological culturing methods using blood cultures. The method is well established and in principle capable of detecting and identifying the vast majority of bacteria and fungi. However, time to result is the major pain point of the technology as the median time to result is 48 hours from sample draw – but it can even take up to a few days. And in 70-80% of all cases clinically evaluated as sepsis, no causative microorganism can actually be identified (doi: 10.3389/fmicb.2016.00697). The reasons for not getting any results are due mainly antimicrobial therapies having been started prior to sample taking, and that microorganisms tend to be dependent on the provision of the right choice of nutrients and other conditions for growing.
Cube Dx' early Pathogen Identification directly from whole blood and other sample matrices reduces time to result to 3 hours. Therefore, a targeted therapy can be chosen very quickly - even for patients already undergoing treatment with antimicrobial agents.